Iranian Journal of Pathology

Abstract Background and Objective: Evaluation of degenerative changes of motoneurons and their related synapses can be useful in understanding the mechanisms of neurodegenerative diseases and their potential treatment. The present electron microscopic and immunohistochemical study investigates the axotomy-induced changes of adult spinal motoneurons up to 3 months following sciatic nerve transection. Materials and Methods: Following unilateral mid-thigh sciatic transection in adult rats, the synaptophysin expression and ultrastructure of synapses in ventral horn of related spinal cord segments were studied 1 day, 1 week, 1 month, and 3 months postoperatively. In all groups the unaxotomized side of spinal cord was considered as control. The pattern of synaptophysin immunolabeling was classified into intact, partial, diffused, and negative types. Results: In 1 week and 1 month groups, the intact pattern decreased and the other 3 patterns increased, whereas 3 months postoperatively the patterns changed vice versa, i.e. intact pattern increased and the other 3 decreased. Electron microscopic studies indicated consistent ultrastructural changes such as synaptic vesicle displacement, synaptic membrane irregularity and synaptic stripping, which were most prominent after 1 month and declined in 3 month group. Conclusion: The present data indicate that following axon injury in adult motoneurons, synapses undergo obvious changes in ultrastructure and synaptophysin distribution, which increase up to 1 month postoperatively, and if the cell survives the insult the changes will attenuate and return to normal conditions thereafter.  

Abstract Background and Objective: BCG vaccination is used in many countries with a high prevalence of TB to prevent childhood tuberculosis meningitis and miliary disease. Local and systemic sideeffects are associated with BCG vaccine. The most critical reaction is disseminated BCG infection which occurs in mostly immunodeficient patients. Materials and Methods: We performed 4 autopsies during 2001-2003 which were suspected for BCGosis clinically and histologically by presence of granulomatous foci in several organs with acid fast bacilli. The mycobacteria were identified by PCR. Their DNA was extracted from the tissue blocks, identified with primers which were designed to detect the RD1 deletion. Results: We found BCG genome by PCR in 3 out of 4 patients. These patients had acid fast bacilli in special staining. Conclusion: Since BCGosis is a fatal and uncommon disease, occurring after vaccination with numerous complications, its diagnosis is of paramount importance and should be considered in the appropriate clinical setting.  

Abstract Background and Objective: Quality control is one of the most important components in order to improve quality assurance in laboratories during analytical steps. For this purpose, coefficient of variation plays an important role. Due to the fast improvement in technology, application of inferential statistics for the comparisons of laboratory techniques, including instrument and chemicals and fast replacement of them would be technically essential. Materials and Methods: In this research study, we tried to determine the precision of one auto-analyzer with refrigerator and the other one without such facility for the analysis of glucose, triglyceride and cholesterol in 30 successive days and compared the coefficient of variations that are an important factor for analytical precision. Results: Comparing the means of aimed groups by paired t-test with P=0.05 in measurement of glucose, triglyceride and cholesterol showed that there was no significant difference between the two instruments. In determination of glucose, triglyceride and cholesterol by auto-analyzer with refrigerator, CV% of these analytes was 1.3%, 1.4%, and 0.9% respectively. By the auto-analyzer without refrigerator, the CV% of those analytes was 1.5%, 2.5% and 1.11% respectively. Conclusion: There is reasonably higher precision for auto-analyzer with refrigerator than the other one.  

Abstract Background and Objective: Cutaneous cytology is the study of scraping or smears obtained from skin lesions. Although not commonly employed, cutaneous cytology has been a useful tool for clinicians due to simplified procedures and high sensitivity and specificity of presurgical clinical diagnosis of common types of skin tumors. This investigation was conducted to study usefulness of cutaneous cytology in diagnosis of basal and squamous cell carcinoma. Methods: We collected 42 skin tumors in total, clinically presumed to be either BCC (n = 31) or SCC (n = 10). Samples were taken by the scraping technique. After smearing the cells onto several glass slides, they were fixed with 96% alcohol. The specimens were stained with Papanicolaou stain. Punch biopsies were taken to confirm the clinical and cytologic impression. Results: Cytodiagnosis and histopathologic examination of 42 cases of BCC (n = 32) and SCC (n = 10) showed a significant concordance between histopathology of skin specimen and cytologic diagnosis with a sensitivity rate of 96.8% and specificity rate of 90% and with a high positive predictive value of 96.8%. Conclusion: Cytologic examination is easy to perform, saves time, and provides a rapid and reliable procedure in diagnosis and confirmation of non-melanoma malignant skin tumors (BCC and SCC).  

Abstract Background and Objective: The aim of this study was to determine the level of plasma high sensitive c-reactive protein (hs-CRP) in preeclampsia and to compare hs-CRP levels between normal pregnant women, mild preeclamptic, and severe preeclamptic women. Materials and Methods: Serum hs-CRP levels were investigated in 40 cases of normal pregnant women, 37 cases with mild preeclampsia and 38 cases with severe preeclampsia in the third trimester of pregnancy. Venous blood samples were collected at admission to the hospital at least 6h before delivery for measurement of hs-CRP by immuno turbidometric method. The student t-test was used for comparison of proportions. Results: There were significant difference in the means serum hs-CRP between normal pregnant women and mild preeclamptic women (P<0.05). Serum concentration of hs-CRP were significantly higher in severe prceclampsia (p<0.05) than normal pregnancy. There were also significant differences in hs-CRP levels between mild and severe preclampsia (P<0.05). Conclusion: We found higher levels of hs-CRP in mild and severe preeclampsia than normal pregnancy and also these results suggest that hs- CRP are increased more in severe preeclamsia than mild preeclampsia , and may be useful in prediction and diagnosis of the severity of preeclampsia.  

Abstract Background and Objective: The opportunistic pathogen Pseudomonas aeruginosa secrets a capsule-like polysaccharide called alginate which is important for evasion of host defenses, especially in patients with suppressed immunity. Method of alginate determination has an important role in the study of microbial alginate. In this study, a novel method for alginate determination by highperformance liquid chromatography (HPLC) was introduced. Materials and Methods: Standard alginate was used for construction of standard curve and standard mucoid and non-mucoid strains of Pseudomonas aeruginosa were used as positive and negative samples respectively. The method of Toyoda was modified for determination of microbial alginate. HPLC determination was performed using a Resolve C18 column (3.9 × 150 mm, Waters, Milford, MA) and acetonitrile-water-butyl acetate (55: 42: 3) as the mobile phase at a flow rate of 0.6 ml/min and detection at 565 nm. Results: The obtained data indicated that minimal detectable concentration of alginate by this method is 20 μg/ml. The method was linear over the range of 1-1000 μg/ml of alginate. The retention time was about 10 min. Conclusion: The proposed method was used for determination of alginate in standard mucoid and non-mucoid strains of Pseudomonas aeruginosa. The results of this study showed that the proposed method is a simple and valid method for bacterial alginate assay.  

Abstract Background and objective: Hemolytic uremic syndrome (HUS) is the most prevalent cause of children renal insufficiency which in many cases (90%) occurs following diarrhea. Hemolytic microangiopathic anemia, thrombocytopenia, and renal insufficiency are main symptoms of hemolytic uremic syndrome. This study aims to consider the relationship between pathologic data of nephro-biopsy and laboratory data of children suffering from the disease. Material and Methods: This study has been carried out in retrospective, cross-sectional and descriptive procedures. For this purpose, 28 patients with an average age of 6 years suffering from uremic hemolytic syndrome referred to Ali Asghar Hospital over the last 10 years. Light microscopic data of glomeruli, arterioles, arteries, interstitial tissue, medullary vessels and tubules were evaluated. Laboratory data including hematology, biochemistry, and urinary tests were extracted from patients’ files. Data were analyzed using SPSS software. Results: The most prevalent damages in glomeruli were decreased capillary lumen and thickening of its wall and in arterioles were mild decrease of lumen and in artery thickening of intima and mild infiltration of inflammatory cells and mild edema in interstitial and hyperemia in vaso recta and the most prevalent pathology in tubules was the existence of cast. Significant relationship was found out between time of recovery of hematological disorders and medullary vessels congestion and reduplication of arterial inner elastic lamina and also improvement of biochemistry changes with glomerulus necrosis and leucocytes assembly in vaso recta. Arteriolar rate with creatinine serum level at discharge time was related and tubular rate with platelet count at discharging time was also related. Conclusion: Biopsy is an important tool for prognosis and det ermination of disease intensity. There was valuable statistical relationship between some laboratory data at the time of referral and pathological data which even could influence intensity or prognosis of disease.  

Abstract   Myoepitheliomas are benign tumors which account for less than 1% of all salivary gland tumors. In this article, we report the clinical, pathologic, and immunohistochemical features of plasmacytoid myoepithelioma of the hard palate in a 73-year-old man having a painless hard palate mass with progressive growth for one month who was admitted in Alzahra Hospital of Isfahan University of Medical Sciences. The patient underwent a complete surgical resection of the tumor. Light microscopy showed a nodule with sharp margins of large cells with plasmacytoid aspect presenting round eccentric nuclei and an abundant and homogenous eosinophilic cytoplasm arranged in sheets and groups separated by an abundant, loose, myxoid and hyalinized matrix. Immunohistochemistry was performed on formalin-fixed and paraffin-embedded tissue with a panel of immunohistochemical markers comprising cytokeratin (CK), vimentin, S100, actin and EMA. Tumor cells showed strong and diffuse positivity for S100 and also CK, vimentin, and actin, but confirming the myoepithelial origin of the tumor, EMA immunostaining was negative.  

Abstract   Tongue base lesions have a diverse and extensive etiology. One of the benign tongue base lesions is schwannoma. Schwannoma and neurofibroma are two tumors of the peripheral nerves originating in the nerve sheaths. Schwannoma account for just over 1% of benign tumors which have been reported in the oral cavity and base of the tongue and with regard to its involved area in the oral cavity is very rare. Here, we report a case of a 13-years-old girl with a schwannoma in the base of tongue, without any symptoms or signs that explored accidentally.  

Abstract   Aneurysms of gastric vessels (Dieulafoy`s disease, caliber-persistent artery) are thought to be of malformative rather than degenerative origin. They are usually single, located in the submucosa, usually on the lesser curvature, and characterized by a large tortuous vessel surmounted by a small defect in the overlying mucosa. When the lesion perforates, massive and sometimes fatal hemorrhage may result. Here, we report one patient with massive upper gastrointestinal bleeding who was treated by surgical resection and later diagnosed with dieulafoy`s malformation in the stomach. Thus, physicians should bear in mind dieulafoy’s lesion when they are faced with massive upper gastrointestinal bleeding.  

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